From the monthly archives: "March 2011"
As a follow-up to a story I posted on earlier, the FDA has said it will not stop the sale of a cheaper version of a drug used to prevent premature births in women.  The drug, called Makena is a progesterone synthetic, which has been made cheaply for years, mixed in compounding pharmacies that are not federally approved.  The FDA said previously that it would enforce regulations against any compound pharmacies mixing the drug, upholding a federal order to allow one company, KV pharmaceutical, to be the sole producers of Makena.

This news comes as a relief for both women and doctors, as previous reports disclosed that the price would jump from $10-$20 to $1,500 for the once-a-week shot.  The FDA released a statement today saying, “In order to support access to this important drug, at this time and under this unique situation, FDA does not intend to take enforcement action against pharmacies” that compound the drug, also known as 17P.

What makes this story unique is that when pharmaceutical companies usually develop a new drug, some pharmacies may try to make a version of the licensed drug after it comes on the market. But in this instance, pharmacies were making it before KV Pharmaceutical.  It was only the government mandate allowing KV sole manufacturing rights that changed things.  What’s more, the FDA’s regulation of special pharmacies is “a gray area” based on agency policies, not laws, noted Alvin J. Lorman, a respected Washington, D.C.-based food and drug lawyer.

Well bravo to the FDA for holding out on enforcing a bad policy.  And shame on the feds for scratching the back of a solitary pharmaceutical company at the expense of at-risk pregnant women.  Thank goodness there was enough of a public outcry to prompt good decision making by the FDA.  Sometimes our voices can be heard, and this is definitely one of those cases.  Good job, people!

Achy, sore neck and upper back following a long day in front of the computer?  Work at a desk and at day’s end feel like your head weighs a ton?  Perhaps you’re a student, head down, nose in the books all day long…that can certainly cause a stiff neck.  Architect?  Lots of driving?  T.V. in bed?  All these activities are common causes of neck and upper back pain and discomfort.

A perfect exercise to help the office worker, student, computer junkie, or couch crasher is something called the Brugger relief position.  This position works by engaging the postural muscles of the spine, holding the body upright.  While it may be uncomfortable for a few people at first (habitual slouchers), engaging the postural muscles takes pressure off the ligaments, which hold the spine up during slouching, and ultimately leads to upper back pain relief.

Watch the video below to see how to properly do the Brugger relief position at home or at work.  Do this exercise every day, minimum five times, until your body is used to the posture.  Then you can do the exercise whenever you start to feel stiff or sore in the neck or upper back.  This exercise does wonders for low back pain, too.

Aaron Rodgers, Superbowl MVP, was raised in a chiropractic familyBooyah!  The Green Bay Packers quarterback was raised in Chico, CA, the son of Dr. Ed Rodgers, chiropractor.

Now we all know how many athletes use chiropractic to optimize their game and extend their careers, so it’s easy for me to point out that chiropractic patients just function better.  Let’s throw Rodgers into the NFL chiropractic club with:

All 32 teams in the NFL have a team chiropractor (watch video below of Daniel Graham getting a game-time chiropractic adjustment)–think it works?  Heck yeah!  If you’ve been considering chiropractic, just know it’s the health choice of champions.

*Congratulations again, Aaron Rodgers and the Green Bay Packers.

I have been showing you exercises to strengthen your upper back, primarily the lower trapezius muscles.  The trapezius is a large diamond-shaped muscle that connects the neck to the shoulders (scapula or shoulder blades).  Although the trapezius is one muscle, we split it into regions based on the actions each does.  So the upper trapezius shrugs the shoulders, the middle trapezius retracts or pulls back the shoulders, and the lower trapezius stabilizes the scapula by anchoring them down so that the arms can do overhead movements.

When the lower trapezius gets weak, it disrupts shoulder biomechanics and can lead to an upper trap-heavy posture, including neck and upper back pain  One way to correct this is by doing wall slide exercises.  Wall slides are NOT lat pull downs; it is a separate and distinct movement, which requires no weights.  Watch the video below to get an idea of how to do proper wall slides.

To be sure, everything has an upside.  Take Tourette syndrome: A recent study has shown that children with the neurological tic disorder perform better on cognitive motor control tests than children without the disorder.  You don’t say?  Yes, the children with Tourette’s showed less impulsivity of movements and greater cognitive control–that is, they were less likely to act without thinking.

Tourette syndrome (TS) is characterized by repetitive, involuntary movements and vocalizations called tics.  The first symptoms of TS are almost always noticed in childhood.  Some of the more common tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking.  Perhaps the most dramatic and disabling tics are those that result in self-harm such as punching oneself in the face, or vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others).

Researchers believe that the enhanced motor control stems from structural and functional brain changes that likely result from the need to constantly suppress tics.  According to one of the study’s authors, Stephen Jackson of the University of Nottingham in the United Kingdom, MRI exams confirmed that the “Tourette’s brain” showed changes in the white-matter connections that allowed different brain areas to communicate with each another.

Pretty amazing how the human brain compensates for disruptions in one area by tightening up the function of another.  If you can’t see the benefit of increased cognitive motor control, then you can’t see the downside to Tourette’s either, because they are two sides of the same coin.  Anybody that knows human physiology knows that the body will do what it needs to survive.  An anastomosis is a connection of blood vessels serving as backup routes for blood to flow if one link is blocked or otherwise compromised.  The body does this all the time, and I see the connections here in this recent Tourette’s study.

The researchers believe that the significance of these findings is that it may help explain why some people with TS who have profound tics during childhood are relatively tic-free by early adulthood, while others continue to have severe tics throughout their life.  They also point out the potential benefits from “brain training” techniques that help people with TS gain control of their symptoms.

Absolutely.  From what we know about neuroplasticity, along with these findings, it seems reasonable that new pathways can be created, benefiting people with TS.  My feeling is that will be seeing more therapeutic work involving brain training not just with Tourette’s but with other neurological disorders, like autism, in the near future.

It’s your choice–want to be scared, or want to be free…you decide.  But here’s the skinny on the radiation risk from Fukushima Dai-ichi nuclear power plant–very, very low risk of adverse public health effects.  The danger zone, as pointed out by physicists (sorry, not pseudo natural-health hacks) is ~ 50 km or 30 miles from the reactor.The following chart was graciously provided by Randall Munroe at xkcd.com.  Please educate yourself:

According to Ben Parr at Mashable:

We encounter sources of radiation every day, from natural background radiation to bananas. (Yes, bananas emit gamma rays, but you’d have to eat 5 million bananas in one sitting to get any kind of radiation sickness.) The absorption of this radiation is measured in units called the sievert (Sv). As the chart explains, we absorb approximately 0.1 microsieverts (μSv) of radiation per day from eating a banana, 10 μSv from background radiation and 20 μSv from a chest x-ray. That’s more than the radiation you’ll absorb from living within 50 miles of a power plant (0.09 μSv). Even a coal power plant generates more radiation (0.3 μSv) because coal has trace amounts of uranium.

It takes a lot more radiation to actually cause harm to a person, although, the maximum yearly dose permitted for a U.S. radiation worker is 50 millisieverts (mSv), more than 200 times the exposure received from a typical X-ray. It takes double that amount though (100 mSv) for an increased risk of cancer and a full 2,000 mSv for severe radiation poisoning to occur.

Fear comes from dis-empowerment, which results from ignorance.  When you are dis-empowered, expect somebody to come in and have power over you, thus the fear-mongers and charlatans capitalizing on your fears.  Educate yourself, and get empowered.  Don’t let fear run your life.

*Than you, Randall for an a$$-kicking chart–job very well done!

Wow!  Leave it to natural disasters to bring out the conspiracy theorist and fear-mongers among us.  As I peruse health news and social media sites regarding the radiation fallout from Japan’s crippled nuclear reactors, I am utterly amazed at what some so-called “health experts (mostly people who fancy themselves experts)” are putting out there.  Shameless.

According to one heavily trafficked scheiße-spreading site, Californians better run for the hills–NOW!  But wait–buy the site’s potassium-iodide pills, which can be shipped by this Monday!  Doh!  Funny that this site screams of one conspiracy theory after another, particularly directed at those they see as wanting to get rich, but not this “natural news” site.  Nooooo….they would never capitalize on a tragedy.

And another site agrees with the first and goes as far as saying that President Obama is in on a conspiracy against YOU!  According to site #1, “Governments are in the business of ‘preventing panic’ by withholding information you need to know. Governments believe that if too many people know the truth, it might start a panic, and even more people could die in the panic than from the event itself.”  Blah, blah, blah…

OK this post is not meant to be a rant against these irresponsible experts (whatever); it’s really meant to say that if you are worried about the radiation comi9ng over from Japan–calm down.  The true experts including the International Atomic Energy Agency, U.S. Department of Energy, South Coast Air Quality Management District*, U.S. Environmental Protection Agency, International Civil Aviation Organization, World Health Organization, President of the US, and Centers for Disease Control all say the radiation levels are now, and continue to be expected to be, below what could be considered a health hazard.  One flight attendants group has even distributed dosimeters to a sampling of its members as assurance that they are not being exposed to harmful radiation levels on trips to and from Japan.

If your twitter guru insists on selling you camu camu juice and potassium iodide pills, all the while telling you how he or she knows better than the agencies listed above, and you really want to believe that–then great, you’ve got time to order and send his/her kids to college.  You want to buy plastic and cover your windows–great, start wrapping.  Otherwise, keep pulling for the Japanese people and anyone currently in Japan, because the radiation threats there are very real.

*The agency’s monitors are part of the U.S. Environmental Protection Agency’s network of more than 100 sensors across the nation that track radiation levels every hour.

Women, women…is coffee good or bad for you?  I going to tell you something that just might perk you up: A cup of coffee a day may keep stroke away.  Perky?  Good.  Check it:

A recent Swedish study found that women who drank at least one cup of coffee per day had a 22-25% lower risk of stroke than women that drank less or no coffee at all.  Researchers followed 34,670 Swedish women, ages 49 to 83, for about 10 years.  They logged the womens’ coffee consumption habits and then checked hospital records to see how many had a stroke after ten years.  Other risk factors like smoking, weight, high blood pressure and diabetes were adjusted for, coffee drinkers still came out ahead.  Now how’s that for a little boost?

Some doctors warn, however, that this study only proves correlation and not cause.  But I say run with it: If you enjoy coffee, drink away.  No studies have been able to link any negative health effects to drinking a couple cups o’ Joe a day, so you’ve got nothing to lose.  If coffee does in fact offer some protective effects against stroke (it’s a vasoconstrictor, you know), then it’s worth the coffee breath, ladies.

Check it out: 35% of fishes collected in the north Pacific Ocean had plastic in their stomachs, according to a group of Southern California researchers.  The Algalita Marine Research Foundation and the Southern California Coastal Water Research Project were looking at the effects of plastic litter floating in the ocean on marine life.

The researchers traveled 1,000 miles off the coast of California, in an area called the Great Pacific Garbage Patch, to collect lanternfishes, small deep sea dwellers that come to the surface after dark to dine on plankton.  Amid the floating bottles, plastic bags and nurdles (tapioca-size plastic pellets), lantern fish and other marine life swim and search for food.  Sometimes they find plankton, sometimes plastic.

The collected fish had, on average, ingested at least two pieces of plastic; however, researchers found as many as 83 pieces of plastic in one fish.  Concerns are that the plastics travel up the food chain and will eventually be ingested by humans.

Although plastics are broken down to a degree by crashing waves, scientists still do not know they ever fully dissolve.  The study was published in the scientific journal Marine Pollution Bulletin and the authors plan to share their findings Friday at the Plastics Are Forever International Youth Summit in Long Beach, where teenagers from the United States and 13 other countries are gathering to share ideas on how to combat plastic pollution.

Man!  How nasty.  First mercury and now plastic.  I know it might sound obvious but…I just don’t understand littering.  I saw a man today discard his banana peel on a parking meter.  Biodegradable, I know, but I wanted to shove it down his throat and tell him to find a garbage can.  Banana peel today, plastic water bottle tomorrow–let it be somebody else’s problem, right?  I know, nobody wants to admit to littering, but it’s coming from somewhere.  Own up, and train yourself not to do it.  Otherwise, enjoy your plastic fishes, numb-nuts.

Used to be a time when preventing premature births was affordable–$10-$20 a week.  Not anymore.  As of next week, the cost of the synthetic progesterone drug, Makena, used to help high-risk pregnant women from delivering preemies (babies born earlier than 37 months), will shoot up to $1,500 a pop!  So much for socialized health care.

Makena, a progesterone synthetic, has been made cheaply for years, mixed in special pharmacies that custom-compound treatments that are not federally approved.  The federal government, however, has approved a suburban St.Louis drug maker, KV Pharmaceutical, to be the sole producer and profiteer of the drug.  Can you say, “Cha-ching!”?

Why on earth, you may be asking.  Proponents (March of Dimes and many obstetricians) of the exclusivity rights for Makena production believe that, by limiting manufacturing to one company, quality and availability of the progesterone drug will increase.

But not even they could have anticipated the enormous price hike, especially since the cost for development and research was taken up by others in the past.

“That’s a huge increase for something that can’t be costing them that much to make. For crying out loud, this is about making money,” said Dr. Roger Snow, deputy medical director for Massachusetts’ Medicaid program.

“I’ve never seen anything as outrageous as this,” said Dr. Arnold Cohen, an obstetrician at Albert Einstein Medical Center in Philadelphia.

“I’m breathless,” said Dr. Joanne Armstrong, the head of women’s health for Aetna, the Hartford-based national health insurer.

A KV subsidiary, Ther-Rx Corp., will market the drug. On Tuesday, it announced a patient assistance program designed to help uninsured and low-income women get the drug at little or no cost.

OK, that’s nice…but what about those forced to purchase health insurance under the Obamacare mandate…and how about the middle class?  Well their insurance will have to pay for it…duh!

So, for many, as the cost to treat one high-risk pregnant woman goes up to nearly $30K, they will likely be offset by increased premiums and other costs (higher deductibles and co-pays, you know the story).  One insurer, Aetna, will continue to pay for the drug, but the price tag will be high.  The insurer currently covers synthetic progesterone for about 1,000 women a year, so the new federal endorsement will cost an estimated $30 million more annually.

And some will go through their state’s Medicaid programs, many of which are broke.  “There’s no question they can’t afford this,” said Matt Salo, executive director of the National Association of Medicaid Directors.

A 2003 study showed progesterone helped prevent early births in women who had a history of spontaneous preterm deliveries. Preterm babies, or preemies, need months of intensive care and often suffer disabilities, if they survive.  The cost of care for a preemie is estimated at $51,000 in the first year alone.

No one knows what causes some women to deliver prematurely, but there is a higher prevalence in black mothers as compared to whites or Hispanics.  Some experts believe that the progesterone drugs help relax the muscles of the uterus, thus delaying premature delivery. 

Well, all I can say is…I told you so.  Frickin’ duh!  What did you think socialized health care was going to do, create a health care utopia?  Dream on.  It will remove competition through mandates, exclusivity, palm-greasing and good ol’ fashioned rear-poking.  Unless, of course, the government chooses to step in and set prices (which the FDA cannot currently do).

Last month, however, KV sent cease-and-desist letters to compounding pharmacies, telling them they could face FDA enforcement actions if they kept making the drug.  Oh well, government favors do go a long way. 

Last post, I talked about the importance of both doctor and patients believing in the chosen treatment to most positively effect healing. The mind cannot be removed from the healing process—not the patient’s mind, not the doctor’s. Case in point: New brain research shows the effects of nocebo on the healing process. No, no, no…not placebo—the perceived or actual improvement in a medical condition from a sham or simulated healing intervention—the nocebo effect!

The nocebo effect is the belief that a person will either fall ill or experience pain, or both. This phenomenon was studied via sophisticated experiment where 22 subjects were zapped with a heat-beaming device onto their legs until they rated the pain as a 70 or more on a 100 point scale.

The researchers then hooked up an IV to give the subjects a powerful morphine-like painkiller remifentanil, which is typically used for surgery patients. It works rapidly but also is metabolized rapidly, so it was able to be switched on and off as researchers alternated between giving the drug or plain fluid.

The volunteers’ brains were scanned as they described how much pain, and pain relief, they experienced at different times. When the researchers induced the burn and clandestinely turned on the drug, the volunteers said their pain improved a fair amount. The painkiller was working, expectations aside.

But here is where mind took over: The researchers next told the volunteers they were about to inject the painkiller even though they’d never turned it off. Those pain ratings dropped even more—meaning expectations of relief doubled the drug’s painkilling benefit.

Finally, the researchers lied again, saying they were stopping the drug and that pain would probably increase. Sure enough, the volunteers’ pain levels soared back up to almost their pre-treated level as grim expectations canceled out the effect of a proven and potent painkiller. Anxiety levels fluctuated similarly.

Why? The brain scans showed changes in neural pain networks that prove the people really did experience the changes in pain that they’d reported. So essentially, the nocebo effect is getting the pain you expect.

Moreover, expecting more pain fired up sections of the brain that control mood and anxiety, the researchers recently reported in the journal Science Translational Medicine. In contrast, anticipating pain relief fired up different regions previously found active in people given placebos. Wow!

Remember, as I said last post, the patient has to believe in the treatment. When a patient goes in expecting not to be helped, expecting to be ill, or expecting pain…well, they’ll likely get it. On the other hand, a patient believing that they will be well, that they will heal, or that a healing technique will work for them will actually set the healing process in motion.

I wrote an article a few years back describing what I call The Five Mental Blocks to Healing, where I described the five ways in which the mind acts as a saboteur in the healing process.  Uncertainty, not trusting the treatment or doctor, or expecting failure are some of these blocks.

Nocebo is a real phenomenon—I’ve seen it plenty in my office. I know when somebody (usually a heterosexual male) is in my office only because his spouse or children wanted him to come that he will probably have a retarded healing experience. Unless, of course, I get through to the person which, fortunately, sometimes I do.

If you are in a situation that needs healing you’ve got to seek and believe—seek treatment and trust the process, that’s all.


Every month I teach a chiropractic re-licensing seminar on sports injuries, and every class I say,

Listen, it’s so important, doctors, that you believe in what you are doing–to the degree that the patient believes you–because if either of you are uncertain, it’ll be much harder for healing to take place.  Both the doctor AND the patient must believe in the treatment, and if only one believes, then it must be the doctor!

Reminds me of an experience my mother-in-law had regarding a wound that was having difficulty healing.  She was seeing a doctor in her home town who recommended a skin graft, but get this, he said, “It is probably not going to work, but it might.”

When I had heard what he said, I asked my wife why her mother was following through with it.  She said her mother wanted to give it a try; she wanted to believe.  Did it work?  No.  Three grafts, three failures.  At the time, I was peeved that the doctor would approach things in that way.  Why would he even go through the procedure if he thought it wouldn’t work?

After the third try failed, to his credit, he did recommend that she check out the NYU Wound Healing Center.  I decided to do some research on the Center, and what did I find right on their website homepage:

Under our innovative, comprehensive, and compassionate care system, healing is not just an outcome, it’s the expectation. This philosophy that every wound can heal is the focus of care at every level – from our wound clinic to the operating room to our research laboratories.

Duh!  I mean what the heck?  If the doctor doesn’t believe the treatment will work, why would the patient?  Here, we’re going to staple your eyelids shut and we’ll check your hemorrhoids in a week…but it’s probably not going to work.  Cha-ching!

The beliefs of both parties in the health care team are an important part of the healing process.  That is exactly why all healing-arts help some people some of the time, yet none helps all people, no matter how effective it is.  There is no such thing as 100% success rate in health care.

But the caveat is that doctors don’t know which people they are going to help and which they are not.  So….it is imperative that doctors approach ALL patients as the ones they are going to help.  If you truly think you are not going to help any one person–and doctors, we have all had patients enter our practices that we knew we couldn’t help–tell them so and refer them out!  How a doctor handles that patient, the one they know they can’t help, is what really counts in the end.  Good doctoring is certainty.

My mother-in-law went to NYU and guess what?  Her wound healed.  Go figure.

Wow!  This one has even me surprised.  A recent study has shown omega-3 fatty acids (FA) to help cancer patients preserve muscle tissue and avoid malnutrition.  By taking fish oil supplements, lung cancer patients avoided losing muscle mass and weight from chemotherapy treatments.  Astounding!

The small study, published in the Feb. 28 online edition of Cancer, looked at 40 people with lung cancer that were undergoing 10 weeks of chemotherapy;16 of the subjects received 2.2 grams of fish oil containing the omega-3 fatty acid, eicosapentaenoic acid (EPA), while the other 24 received chemotherapy alone.  The results: the chemo only group lost an average of just over 5 pounds, while the chemo plus omega-3 FAs group lost no weight at all.  Further, 70% of the fish oil group either gained or kept their original muscle mass, while 30% of the no fish oil group lost muscle mass.  I’m blown away.

This study is important for the obvious reason–possible supplemental treatment to help keep cancer patients undergoing chemo from wasting away.  But for me the real fascination is how amazing the body is.  Give it what it needs and watch Innate Intelligence take over to produce health.  Incredible!

Some are cautioning against premature optimism.  Says one registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Dallas,

“I would caution that the amount of pure concentrated fish oil supplement the people in this study were given is a lot–much, much more than any recommended dietary allowance, along the lines of two to three servings of fish per week…[P]eople should definitely not go out and start consuming huge amounts of fish oil.”

That’s one way of looking at it.  But as far as I’m concerned, we can forget the optimism and try marveling.  Ain’t the human body awe-inspiring?  Yes I’m surprised by this study, simply because sometimes I cannot grasp the magnitude of intelligence operating through the human life form…and the universe.  It sure is humbling.  A good reminder that our educated mind cannot improve on nature’s order.  Not yet anyhow…and maybe never.

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